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Iqbal Pahlevi Adeputra Nasution
Departemen Bedah, Fakultas Kedokteran, Universitas Sumatera Utara, Medan
Health Professions Medicine & Pharmacology Public Health

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Journal : Cermin Dunia Kedokteran

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Perbandingan Akurasi Diagnostik Kadar Procalcitonin dan C-Reactive Protein pada Pasien Apendisitis Anak di RSUP H.Adam Malik Medan dan RSUD Dr.Pirngadi Medan Suhaymi, Ery; Fikri, Erjan; Nasution, Iqbal Pahlevi Adeputra
Cermin Dunia Kedokteran Vol 43, No 10 (2016): Anti-aging
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (158.609 KB) | DOI: 10.55175/cdk.v43i10.869

Abstract

Latar Belakang: Diagnosis appendisitis akut masih merupakan tantangan, terutama pada kelompok usia anak. Oleh karena itu diperlukan suatu alat diagnostik yang sensitif dan spesifik. Tujuan : Membandingkan akurasi Procalcitonin (PCT) dengan C-Reactive Protein (CRP) untuk mendiagnosis apendisitis anak. Metode: Penelitian potonglintang dengan analisis deskriptif dan analitik terhadap 31 pasien usia di bawah 18 tahun yang datang ke IGD RSUP H. Adam Malik Medan dengan gejala apendisitis dan telah menjalani appendektomi dari bulan Desember 2014 hingga Juli 2015. Seluruh sampel darah diambil preoperatif dan nilai PCT dan CRP diukur. Dilakukan apendektomi dan pemeriksaan histopatologi pasca operasi. ROC nilai sensitivitas, spesifisitas, prediksi positif dan prediksi negatif masing-masing pemeriksaan laboratorium dan kombinasi keduanya dianalisis menggunakan kurva. Hasil : Didapatkan 14 ( 45,2%) laki-laki dan 17 (54,8%) perempuan, pada kelompok umur 12 – 18 tahun (58,1%) dan kelompok umur < 12 tahun (41,9%). Kadar CRP meningkat pada 91,7% penderita appendisitis akut dan pada 84,2% penderita appendisitis komplikasi. Sensitivitas uji diagnostik 84,2% dan spesifisitas 8,3% serta akurasi pengukuran kadar CRP 54,8%. Rentang kadar CRP untuk appendisitis akut 0,69 – 17,10 mg/l dengan rerata 10,11 ± 4,74 mg/l dan untuk appendisitis komplikasi 3,70 – 19,70 mg/l dengan rerata 12,27 ± 4,82 mg/l. Kadar PCT dijumpai meningkat pada 91,7% penderita appendisitis akut dan pada 100% penderita appendisitis komplikasi. Sensitivitas uji diagnostik 100% dan spesifisitas 8,3% serta akurasi pengukuran kadar PCT 64,5%. Rentang kadar PCT sangat besar untuk appendisitis akut 0,04 – 55,50 ng/ml dengan rerata 10,60 ± 15,95 ng/ml dan untuk appendisitis komplikasi 0,75 – 151,70 ng/ml dengan rerata 15,98 ± 33,44 ng/ml. Simpulan : Pemeriksaan PCT pada pasien appendisitis memiliki sensitivitas 100% dan spesifisitas 8,3% dan memiliki nilai akurasi lebih tinggi (64,5%) dibandingkan pemeriksaan CRP (54,8%) dengan sensitivitas 84,2% dan spesifisitas 8,3%. PCT dan CRP memiliki peranan penting untuk mendukung diagnosis klinis apendisitis akut pada anak.Background: Diagnosis of acute appendicitis remains a challenge, especially among children. A sensitive and specific diagnostic tool is needed. Objective: To compare the accuracy of Procalcitonin (PCT) and C-Reactive Protein (CRP) in diagnosing pediatric appendicitis. Method: Cross-sectional study with descriptive and analytical analysis on 31 patients under 18 years of age in the emergency department of RSUP H. Adam Malik with symptoms of appendicitis and underwent appendectomy from December 2014 until July 2015. Blood samples were taken to determine the value of preoperative PCT and CRP. Postoperative histopathological examination was done. ROC curve was used to analyze the sensitivity, specificity, positive predictive and negative predictive value of each and combination of laboratory tests. Results: Samples were 14 (45.2%) male and 17 (54.8%) female; aged 12-18 years (58.1% ) and <12 years (41.9%). The range of values of CRP levels for acute appendicitis were 0.69 - 17.10 mg / l (mean 10.11 ± 4.74 mg / l) and for complicated appendicitis were 3.70 - 19.70 mg / l (mean 12.27 ± 4.82 mg / l). A CRP level was increased in 91.7% patients with acute appendicitis, and in 84.2% patients with complications. Sensitivity and specificity of the diagnostic test was 84.2% and 8.3% respectively, the accuracy of measurement of CRP levels was 54.8%. PCT levels was increased in 91.7% patients with acute appendicitis, and in 100% patients with complicated appendicitis. Sensitivity and specificity were 100% and 8.3% respectively and the accuracy of measurement of PCT levels is 64.5%. The range of values of PCT levels for acute appendicitis is 0.04 to 55.50 ng / ml, mean 10.60 ± 15.95 ng / ml and for complicated appendicitis of 0.75 to 151.70 ng / ml, mean 15.98 ± 33.44 ng / ml. Conclusion: Examination of PCT in patients with appendicitis had a 100% sensitivity and 8.3% specificity of and has a higher accuracy (64.5%) compared with CRP examination (54.8%) with a sensitivity of 84.2% and a specificity of 8.3%. 
Perbandingan Akurasi Diagnostik Kadar Procalcitonin dan C-Reactive Protein pada Pasien Apendisitis Anak di RSUP H.Adam Malik Medan dan RSUD Dr.Pirngadi Medan Ery Suhaymi; Erjan Fikri; Iqbal Pahlevi Adeputra Nasution
Cermin Dunia Kedokteran Vol 43, No 10 (2016): Anti-aging
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i10.869

Abstract

Latar Belakang: Diagnosis appendisitis akut masih merupakan tantangan, terutama pada kelompok usia anak. Oleh karena itu diperlukan suatu alat diagnostik yang sensitif dan spesifik. Tujuan : Membandingkan akurasi Procalcitonin (PCT) dengan C-Reactive Protein (CRP) untuk mendiagnosis apendisitis anak. Metode: Penelitian potonglintang dengan analisis deskriptif dan analitik terhadap 31 pasien usia di bawah 18 tahun yang datang ke IGD RSUP H. Adam Malik Medan dengan gejala apendisitis dan telah menjalani appendektomi dari bulan Desember 2014 hingga Juli 2015. Seluruh sampel darah diambil preoperatif dan nilai PCT dan CRP diukur. Dilakukan apendektomi dan pemeriksaan histopatologi pasca operasi. ROC nilai sensitivitas, spesifisitas, prediksi positif dan prediksi negatif masing-masing pemeriksaan laboratorium dan kombinasi keduanya dianalisis menggunakan kurva. Hasil : Didapatkan 14 ( 45,2%) laki-laki dan 17 (54,8%) perempuan, pada kelompok umur 12 – 18 tahun (58,1%) dan kelompok umur < 12 tahun (41,9%). Kadar CRP meningkat pada 91,7% penderita appendisitis akut dan pada 84,2% penderita appendisitis komplikasi. Sensitivitas uji diagnostik 84,2% dan spesifisitas 8,3% serta akurasi pengukuran kadar CRP 54,8%. Rentang kadar CRP untuk appendisitis akut 0,69 – 17,10 mg/l dengan rerata 10,11 ± 4,74 mg/l dan untuk appendisitis komplikasi 3,70 – 19,70 mg/l dengan rerata 12,27 ± 4,82 mg/l. Kadar PCT dijumpai meningkat pada 91,7% penderita appendisitis akut dan pada 100% penderita appendisitis komplikasi. Sensitivitas uji diagnostik 100% dan spesifisitas 8,3% serta akurasi pengukuran kadar PCT 64,5%. Rentang kadar PCT sangat besar untuk appendisitis akut 0,04 – 55,50 ng/ml dengan rerata 10,60 ± 15,95 ng/ml dan untuk appendisitis komplikasi 0,75 – 151,70 ng/ml dengan rerata 15,98 ± 33,44 ng/ml. Simpulan : Pemeriksaan PCT pada pasien appendisitis memiliki sensitivitas 100% dan spesifisitas 8,3% dan memiliki nilai akurasi lebih tinggi (64,5%) dibandingkan pemeriksaan CRP (54,8%) dengan sensitivitas 84,2% dan spesifisitas 8,3%. PCT dan CRP memiliki peranan penting untuk mendukung diagnosis klinis apendisitis akut pada anak.Background: Diagnosis of acute appendicitis remains a challenge, especially among children. A sensitive and specific diagnostic tool is needed. Objective: To compare the accuracy of Procalcitonin (PCT) and C-Reactive Protein (CRP) in diagnosing pediatric appendicitis. Method: Cross-sectional study with descriptive and analytical analysis on 31 patients under 18 years of age in the emergency department of RSUP H. Adam Malik with symptoms of appendicitis and underwent appendectomy from December 2014 until July 2015. Blood samples were taken to determine the value of preoperative PCT and CRP. Postoperative histopathological examination was done. ROC curve was used to analyze the sensitivity, specificity, positive predictive and negative predictive value of each and combination of laboratory tests. Results: Samples were 14 (45.2%) male and 17 (54.8%) female; aged 12-18 years (58.1% ) and <12 years (41.9%). The range of values of CRP levels for acute appendicitis were 0.69 - 17.10 mg / l (mean 10.11 ± 4.74 mg / l) and for complicated appendicitis were 3.70 - 19.70 mg / l (mean 12.27 ± 4.82 mg / l). A CRP level was increased in 91.7% patients with acute appendicitis, and in 84.2% patients with complications. Sensitivity and specificity of the diagnostic test was 84.2% and 8.3% respectively, the accuracy of measurement of CRP levels was 54.8%. PCT levels was increased in 91.7% patients with acute appendicitis, and in 100% patients with complicated appendicitis. Sensitivity and specificity were 100% and 8.3% respectively and the accuracy of measurement of PCT levels is 64.5%. The range of values of PCT levels for acute appendicitis is 0.04 to 55.50 ng / ml, mean 10.60 ± 15.95 ng / ml and for complicated appendicitis of 0.75 to 151.70 ng / ml, mean 15.98 ± 33.44 ng / ml. Conclusion: Examination of PCT in patients with appendicitis had a 100% sensitivity and 8.3% specificity of and has a higher accuracy (64.5%) compared with CRP examination (54.8%) with a sensitivity of 84.2% and a specificity of 8.3%. 
Co-Authors Binsyah Sari Indah Gajah Manik Erjan Fikri Ery Suhaymi